In 1979, newspapers were the preferred news source at 42% followed closely by television at 41%. In 2009, 60% preferred television while newspapers dropped to 14%! The internet (which didn't really exist in 1979) was virtually tied with newspapers at 13%. The precipitous drop for newspapers shows why chapter 13 is more prevalent than chapter stories.

Health Insurance.

But here is the feature item of the day. In 1979, the question was asked about government insurance vs. private insurance. Here are the results:

I think that reversal is amazing. During that 30 year period we have had several attempts at private insurance reform and a number of health care task forces. And although private insurers have spent million, even billions, in lobby efforts, the trend toward single payer has continued to grow.

Single payer advocates need to forge ahead, even in the face of the deep pockets of their adversaries.

It's That Time of Year -- Medicare Doughnut Holes

I'm a pharmacist and at this point of the year I go into explanation mode in repsonse to the raised eyebrows, quizzical stares, and looks of exasperation. It's time for that senior doughnut hole moment.

In prescription drug coverage, pharmacies that deal with Medicare coverage -- and that would be pretty much all of us -- have become all too familiar with that term. The authors of the Medicare bill, in their infinite wisdom, decided to save money by establishing a coverage gap in prescription drug benefits. Medicare prescription drug coverage has normal insurance coverage up to a certain dollar benefit level. Then all of a sudden coverage stops. The patient has to purchase the drug for a price close to regular retail until they have paid an additional out of pocket expense of $3,850. If they accumulate that much in payments, then coverage resumes for the remainder of the year.

For people with chronic illnesses, like diabetes or epilepsy, this is about the time of the year when that doughnut hole rears its "no coverage" head. Patients who are used to small percentage co-pays are suddenly hit by full price of the medication. And that can be pretty heavy sticker shock.

Naturally, since I am the one taking their money, it must be my fault. The reams of paper the insurance companies send out to outline the coverage of their policies tend to gloss over the doughnut hole concept. It gets non-confrontational names like: "coverage interruption" or "benefit delay". You don't see the words -- your coverage ends and you pay full out of pocket pricing.

Some seniors just can't do it. They stop taking the drug for the rest of the year or they try to get by on lower doses or skipping days. Some cut back on other budget items. But all of them are unhappy.

When the Medicare deal was reached, there was one pretty important participant that was not asked to compromise on the cost of this venture -- the drug companies.

Medicare cannot enter into pricing contracts with the manufacturers.. even though Medicaid and the Veteran's Administration do routinely. In fact, it keeps them (Medicaid and the VA) somewhat solvent. In Medicare's case, potential drug savings are paid directly by Medicare consumers as full price purchasing. It is a trade off that the Bush administration negotiated on your behalf.

Aren't you glad? Oh well, must be time for a doughnut and coffee... but remember you will pay for that doughnut hole later.

Big PhRMA Wants to Buy In

In today's politics, if you want to see the direction of any policy inititative, the first thing to do is.....follow the money.

A Politico article by Jeanne Cummings in her Pit Boss column has a bit of a scary title -- PhRMA Goes BiPartisan.

PhRMA is the trade association for all the big pharmaceutical companies. After the Democrats took over Congress, PhRMA hired former Louisiana Congressman Billy Tauzin as their chief spokesperson and lobbyist. While part of the Republican majority, he brokered many a favorable deal for PhRMA, so he was the natural choice.

Tauzin is a smart man and he has a pragmatic look at the future of health care. He sees a lot of Democratic influence. He even plays nice with the current presidential candidates:

Both Hillary Rodham Clinton and Barack Obama have proposed health care reform plans that emphasize preventive care and using government incentives and mandates to drive people to buy insurance. ?To the extent they do that, they are right on target,? Tauzin said. ?I support that.?

Never trust what Tauzin supports. PhRMA is changing their tactics. They know the public is restless with the current broken system. They are getting on board with the "incremental" reforms that both the Clinton and Obama campaigns are promoting.

Tauzin wants PhRMA to be a player in how this is constructed. Just as they were heavily involved in the Medicare Part D plan. And they are backing up their "support" with money.

In 2006, PhRMA put $20 million into campaign coffers. 70% of it went to Republicans. So far, they have "invested" $8 million in this cycle and it gets doled out in a 50-50 split. As Tauzin explains:

?They were supporting their (Republican) friends. We agreed with them. I understand that,? he says. ?My position is: We don?t have any enemies. We?re never going to desert old friends, but I?m ready to make new ones every day,? Tauzin explained?

Translation: Why pay for damaged goods when you can buy new?

And Tauzin is making progress....

When newly elected House Speaker Nancy Pelosi (D-Calif.) was pushing through a health care bill last winter during the Democrats? first 100 days in power, PhRMA was not invited to a background briefing. Tauzin and Pelosi now have a cordial working relationship, and PhRMA ran advertisements last fall to help Democrats pass an expanded children?s health initiative. President Bush vetoed it.

The snakes are in the pit.

Tauzin is shrewd and knows the game. The Democrats want reform and they have the power -- they could have more with a Democrat in the White House. Tauzin knows that some kind of change is coming but he will make sure PhRMA has a voice at the table. And they like to control the table.

Tauzin has one worry:

While Tauzin embraces many of the Democratic proposals, he can?t support plans by both Obama and Clinton to create a government insurance program that could serve as an alternative for people who can?t get private coverage.

?I don?t like any notion that the government is going to come in and start competing with private insurance,? he said. ?The government becomes a price fixer, and it will drive out private offerings. It ends up being a single-payer system eventually.?